Standardized exercise oximetry predicts postpneumonectomy outcome

Ann Thorac Surg. 1997 Aug;64(2):328-32; discussion 332-3. doi: 10.1016/S0003-4975(97)00474-8.


Background: We have developed a safe, simple, and easily performed standardized exercise oximetry outpatient test to assess patients undergoing lung resections. We studied its ability to predict outcome after pneumonectomy in 46 consecutive patients over a 5-year period.

Methods: Room air oximetry is initially performed at rest. The patient then begins to exercise on a stair-stepper apparatus (Stamina Stepper), which provides uniform resistance to stepping. Oxygen saturation values are noted at 10, 20, and 30 steps, equivalent to climbing three flights of stairs. Group 1 consisted of the patients who either had a resting saturation less than 90%, or desaturation greater than or equal to 4% during exercise. Group 2 consisted of all patients who had a preoperative forced expiratory volume in 1 second of 60% or less. Group 3 consisted of all patients who had a predicted postoperative forced expiratory volume in 1 second of 40% or less. Group 4 consisted of patients who had a predicted postoperative diffusing capacity of 40% or less.

Results: There were four deaths (8.6%), 12 patients (26%) remained in the intensive care unit 4 or more days, and 11 patients (23%) suffered major morbidity. Desaturation during exercise (group 1) significantly predicted longer intensive care unit stay (p = 0.0002) and incidence of major morbidity (p < 0.0001). Groups 2, 3, and 4 were not significantly predictive of either longer intensive care unit stay or major morbidity.

Conclusions: Standardized exercise oximetry performed in the outpatient facility is highly predictive of major morbidity and prolonged intensive care unit stay after pneumonectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / physiopathology
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Exercise Test*
  • Female
  • Forced Expiratory Volume
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Oximetry*
  • Pneumonectomy* / mortality
  • Postoperative Complications
  • Pulmonary Diffusing Capacity
  • Risk Factors
  • Spirometry
  • Treatment Outcome